scholarly journals Impact of Antihypertensive Agents on Central Systolic Blood Pressure and Augmentation Index: A Meta-Analysis

2015 ◽  
Vol 29 (4) ◽  
pp. 448-457 ◽  
Author(s):  
Tracey J. McGaughey ◽  
Emily A. Fletcher ◽  
Sachin A. Shah
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Augmentation Index ◽  
Meta Analysis ◽  
Antihypertensive Agents ◽  
Central Systolic Blood Pressure

Abstract P014: Impact of Antihypertensive Class on Central Systolic Blood Pressure and Augmentation Index: A Meta-Analysis

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Tracey J McGaughey ◽  
Emily A Fletcher ◽  
Sachin A Shah
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Publication Bias ◽  
Visual Inspection ◽  
Augmentation Index ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Central Systolic Blood Pressure ◽  
Funnel Plots ◽  
The Impact

Introduction: New evidence suggests central systolic blood pressure (cSBP) is a superior predictor of adverse cardiovascular outcomes as compared to peripheral systolic blood pressure (pSBP). Additionally, augmentation index (AI) provides a surrogate assessment of vascular stiffness. We performed a meta-analysis to assess the impact of antihypertensive drug classes on cSBP and AI. METHODS: Search terms related to blood pressure and AI were used to identify relevant articles in PubMed, Cochrane Library and CINAHL limited to randomized trials in humans and publications in English. Appropriate data on cSBP, pSBP and AI were extracted along with other study characteristics. Weighted mean differences (WMD) between the pSBP and cSBP with 95% confidence intervals (CI) were calculated using the DerSimonian-Laird random-effects methodology. For AI, the WMD from baseline was determined. Further, the data was sorted by antihypertensive class (angiotensin converting enzyme inhibitors (ACE-Is), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs) and diuretics) to determine their impact on cSBP and AI. Subgroup analyses were performed to assess robustness of results by limiting to the fixed-effects model, a primary diagnosis of hypertension, and excluding studies with JADAD scores < 3. Publication bias was assessed using the Egger’s statistic and visual inspection of funnel plots. Statistical heterogeneity was assessed using the I2 statistic. RESULTS: Fifty-one and 58 studies incorporating 4381 and 3716 unique subjects were included for cSBP and AI respectively. Overall, antihypertensives reduced pSBP more than cSBP (2.52mmHg, 95%CI 1.35 to 3.69; I2 =21.9%). ACE-Is, ARBs, CCBs and diuretics reduced cSBP and pSBP in a similar manner (-2.40mmHg, 95%CI -4.89 to 0.08; 1.12mmHg, 95%CI -2.25 to 4.49; 1.01mmHg, 95%CI -2.17 to 4.19; 0.65mmHg, 95%CI -2.47 to 3.77 respectively). BBs posed a significantly greater reduction in pSBP as compared to cSBP (5.19mmHg, 95%CI 3.21 to 7.18). The change in AI from baseline was (-3.09, 95%CI -3.90 to -2.28; I2 =84.5%). A significant reduction in AI was seen with ACE-Is, ARBs, CCB and diuretics (-5.61, 95%CI -6.95 to -4.27; -5.28, 95%CI -8.61 to -1.95; -5.36, 95%CI -6.95 to -3.77; -3.24, 95%CI -5.45 to -1.03 respectively). BBs reduced AI non-significantly (-0.32, 95% CI -1.48 to 0.84). While the Egger’s statistic showed a lack of publication bias (p>0.125), it cannot be ruled out based on visual inspection of funnel plots. CONCLUSIONS: BBs are not as beneficial in reducing cSBP as opposed to ACE-Is, ARBs, CCBs and diuretics. In contrast, ACE-Is, ARBs, CCBs and diuretics significantly reduce AI, which is not evident with BB therapy. The views expressed in this material are those of the author(s), and do not reflect the official policy or position of the U.S. Government, the Department of Defense, or the Department of the Air Force.

Abstract P100: Enhanced External Counterpulsation Reduces Central Blood Pressure In Stable Angina Patients: A Meta Analysis

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Elizabeth Lindemann ◽  
Kevin Pham ◽  
Gautam Kedia ◽  
Ananth Prasad ◽  
Sachin A Shah
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Stable Angina ◽  
Augmentation Index ◽  
Meta Analysis ◽  
Central Hemodynamics ◽  
External Counterpulsation ◽  
Before And After ◽  
Enhanced External Counterpulsation

Introduction: Emerging evidence suggests central systolic blood pressure (cSBP) and augmentation index are superior predictors of adverse cardiovascular outcomes as compared to peripheral systolic blood pressure (pSBP). Enhanced external counterpulsation (EECP) is a non-invasive treatment modality approved for the management of refractory angina. The degree of benefit from EECP on central hemodynamics and arterial stiffness remains unknown. This meta-analysis evaluated the effect of EECP on peripheral (office) blood pressure and central hemodynamic parameters. Methods: A comprehensive literature search was conducted in Pubmed, CINAHL, and Cochrane Library databases. All prospective clinical trials assessing the impact of EECP in patients with stable angina and CAD were included. Studies were excluded for not completing a full course of EECP, having a baseline peripheral systolic blood pressure &lt100 mmHg, or not reporting adequate data for analysis. The primary endpoint was the change in cSBP before and after EECP. The change in pSBP, pDBP, cDBP, and augmentation index before and after EECP were also assessed. The weighted mean difference using the DerSimonian and Laird random-effect model was utilized for determining the change in each parameter before and after EECP. Statistical heterogeneity was evaluated using the Egger’s bias statistic. Results: Five studies containing 137 unique patients were included for the cSBP analysis. cSBP was reduced significantly by -7.56 mmHg (95% CI -11.83 to -3.28; Cochrane Q=1.81) post-EECP. In the same set of studies, pSBP was reduced significantly by -9.65 mmHg (95% CI -14.32 to -4.98) post-EECP. pDBP [-4.67 mmHg (95% CI -8.56 to -0.77)] was reduced post-EECP, while no changes were evident in cDBP. Augmentation index was reduced by -3.74% (95% CI -7.05 to -0.43) post-EECP. Two studies included a sham-EECP intervention arm and demonstrated no significant changes in cSBP [0.67 mmHg (95% CI -5.66 to 7.01)] or other parameters. Conclusion: EECP significantly reduced cSBP and pSBP by approximately 8 mmHg and 10 mmHg respectively. EECP also demonstrated a mild improvement in arterial stiffness, which translates to reduced wasted left ventricular energy and myocardial oxygen demand. In patients with stable angina and CAD, EECP exerts beneficial effects in both peripheral and central hemodynamics but whether these benefits are sustained over a longer duration need further exploration.

Low night-time heart rate is longitudinally associated with lower augmentation index and central systolic blood pressure in hypertension

2018 ◽  
Vol 118 (3) ◽  
pp. 543-550 ◽  
Author(s):  
Paolo Palatini ◽  
Francesca Saladini ◽  
Lucio Mos ◽  
Claudio Fania ◽  
Adriano Mazzer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Augmentation Index ◽  
Night Time ◽  
Central Systolic Blood Pressure

scholarly journals Vascular function and stiffness: population epidemiology and concordance in Australian children aged 11–12 years and their parents

BMJ Open ◽  
2019 ◽  
Vol 9 (Suppl 3) ◽  
pp. 34-43 ◽  
Author(s):  
Freya K Kahn ◽  
Melissa Wake ◽  
Kate Lycett ◽  
Susan Clifford ◽  
David P Burgner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulse Wave Velocity ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Wave Velocity ◽  
Vascular Function ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Central Systolic Blood Pressure ◽  
Parent Child

ObjectivesTo describe the epidemiology and parent–child concordance of vascular function in a population-based sample of Australian parent–child dyads at child age 11–12 years.DesignCross-sectional study (Child Health CheckPoint), nested within a prospective cohort study, the Longitudinal Study of Australian Children (LSAC).SettingAssessment centres in seven major Australian cities and eight regional towns or home visits, February 2015–March 2016.ParticipantsOf all participating CheckPoint families (n=1874), 1840 children (49% girls) and 1802 parents (88% mothers) provided vascular function data. Survey weights and methods were applied to account for LSAC’s complex sample design and clustering within postcodes and strata.Outcome measuresThe SphygmoCor XCEL assessed vascular function, generating estimates of brachial and central systolic blood pressure and diastolic blood pressure, central pulse pressure, augmentation index and carotid–femoral pulse wave velocity. Pearson’s correlation coefficients and multivariable linear regression models estimated parent–child concordance.ResultsHypertension was present in 3.9% of children and 9.0% of parents. Mean child and parent values for augmentation index were 4.5% (SD 11.6) and 21.3% (SD 12.3), respectively, and those for carotid–femoral pulse wave velocity were 4.48 m/s (SD 0.59) and 6.85 m/s (SD 1.14), respectively. Parent–child correlation for brachial systolic blood pressure was 0.20 (95% CI 0.15 to 0.24), brachial diastolic blood pressure 0.21 (95% CI 0.16 to 0.26), central systolic blood pressure 0.21 (95% CI 0.16 to 0.25), central diastolic blood pressure 0.21 (95% CI0.17 to 0.26), central pulse pressure 0.19 (95% CI 0.14 to 0.24), augmentation index 0.28 (95% CI 0.23 to 0.32) and pulse wave velocity 0.22 (95% CI 0.18 to 0.27).ConclusionsWe report Australian values for traditional and more novel vascular function markers, providing a reference for future population studies. Cross-generational concordance in multiple vascular function markers is already established by age 11–12 years, with mechanisms of heritability remaining to be explored.

Comparison of estimates of central systolic blood pressure and peripheral augmentation index obtained from the Omron HEM-9000AI and SphygmoCor systems

2009 ◽  
Vol 3 (1) ◽  
pp. 24 ◽  
Author(s):  
Charlotte J. Richardson ◽  
Kaisa M. Maki-Petaja ◽  
Barry J. McDonnell ◽  
Stacey S. Hickson ◽  
Ian B. Wilkinson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Augmentation Index ◽  
Central Systolic Blood Pressure

scholarly journals Comparison of two measuring instruments, B-pro and SphygmoCor system as reference, to evaluate central systolic blood pressure and radial augmentation index

2012 ◽  
Vol 35 (6) ◽  
pp. 617-623 ◽  
Author(s):  
Luis Garcia-Ortiz ◽  
◽  
José I Recio-Rodríguez ◽  
Joan J Canales-Reina ◽  
Alfredo Cabrejas-Sánchez ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Augmentation Index ◽  
Measuring Instruments ◽  
Central Systolic Blood Pressure

scholarly journals Isolated systolic hypertension of the young and its association with central blood pressure in a large multi-ethnic population. The HELIUS study

2018 ◽  
Vol 25 (13) ◽  
pp. 1351-1359 ◽  
Author(s):  
Daan W Eeftinck Schattenkerk ◽  
Jacqueline van Gorp ◽  
Liffert Vogt ◽  
Ron JG Peters ◽  
Bert-Jan H van den Born
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Systolic Hypertension ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Normal Blood Pressure ◽  
Isolated Systolic Hypertension ◽  
Ethnic Population ◽  
Helius Study ◽  
Central Systolic Blood Pressure

Background Isolated systolic hypertension (ISH) of the young has been associated with both normal and increased cardiovascular risk, which has been attributed to differences in central systolic blood pressure and arterial stiffness. Methods We assessed the prevalence of ISH of the young and compared differences in central systolic blood pressure and arterial stiffness between ISH and other hypertensive phenotypes in a multi-ethnic population of 3744 subjects (44% men), aged <40 years, participating in the HELIUS study. Results The overall prevalence of ISH was 2.7% (5.2% in men and 1.0% in women) with the highest prevalence in individuals of African descent. Subjects with ISH had lower central systolic blood pressure and pulse wave velocity compared with those with isolated diastolic or systolic-diastolic hypertension, resembling central systolic blood pressure and pulse wave velocity values observed in subjects with high-normal blood pressure. In addition, they had a lower augmentation index and larger stroke volume compared with all other hypertensive phenotypes. In subjects with ISH, increased systolic blood pressure amplification was associated with male gender, Dutch origin, lower age, taller stature, lower augmentation index and larger stroke volume. Conclusion ISH of the young is a heterogeneous condition with average central systolic blood pressure values comparable to individuals with high-normal blood pressure. On an individual level ISH was associated with both normal and raised central systolic blood pressure. In subjects with ISH of the young, measurement of central systolic blood pressure may aid in discriminating high from low cardiovascular risk.

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